Depression and Anxiety Not Linked With Medication Overuse in Migraine

The first treatments often prescribed for Migraine are abortives or other acute pain medications to relieve the symptoms of an attack. As tempting as it may be to rely only on acute treatments, using many of these medications too frequently can cause medication overuse headache (MOH). While it is understood that chronic Migraine is associated with MOH, less is understood about the link between MOH and mental health comorbidities such as anxiety and depression.

Previous research suggests that depression and anxiety may be a risk factor for MOH. Those studies have often relied on patient recall rather than collecting data in real time.

A recent study investigated the association between Migraine-related disability, medication overuse, and comorbid depression and anxiety.

Study Methods

Subjects recorded presence or absence of headache in daily electronic diary

Study Results

Chronic Migraine present in 16 percent

Medication overuse found in 17.2 percent

Anxiety disorders present in 34.4 percent

Depressive disorders present in 45.7 percent

No demographic variable associated with medication overuse

Psychiatric disorders not associated with medication overuse

HIT-6 results not associated with medication overuse

When controlled for headache days, MIDAS results not associated with medication overuse

Study Conclusions

Migraine patients with comorbid anxiety or depressive disorders were not more likely to overuse acute medications

Chronic migraine was the only predictor of medication overuse

This was the first study to obtain these findings

Previous studies have used retrospective recall (relying on patient memory of past events) that may have been less accurate

Implication for patients

As further research clarifies the association between medication overuse, transition from episodic to chronic migraine, and psychiatric comorbidities, we can expect improvements in patient screening and treatment recommendations. In the meantime, increase your odds of Migraine success by sharing your mental health history with your Migraine doctor.